The purpose of this study was to examine the psychological consequences of the Boko Haram insurgency based on the lived experience of Nigerian children exposed to terrorism in northeastern Nigeria. I employed phenomenological qualitative
methodology to determine the lived experience of the study participants exposed to Boko Haram terrorism in northeastern Nigeria. Prior research on impacts of the Boko Haram insurgency in Nigeria primarily focused on economic impacts on the adult population.
To fill the gap, the literature review for this study focused mainly on psychological effects of the Boko Haram insurgency on Nigerian children. Prior research has not examined how Boko Haram has impacted the educational experience of children in Nigeria, programs and services that are perceived as available and helpful in improving individuals’ ability to cope with the trauma of terrorism, or barriers to improving the mental health of the children in Nigeria. Examining these factors through the lived experience of children exposed to the Boko Haram insurgency is important in decreasing the psychological impact of the Boko Haram insurgency as well as developing reform efforts and policies to reduce the psychological effects of terrorism on Nigerian children.
In this study, all participants identified the psychological impacts of the Boko Haram insurgency and the effects of terrorism on their education. The study participants also identified programs and services that were available to help them cope with their trauma, as well as programs and services that promoted their coping and adjustment after exposure to the Boko Haram insurgency. In addition, they identified barriers that existed
to improving their mental health. All participants shared their grief and mourning following Boko Haram attacks on their communities and schools, which resulted in the death of their parents, friends, and/or other family members. Their initial reactions to Boko Haram attacks reflected a human “normative” response to terrorism. These
responses aligned with Peredo’s (2013) argument that children’s reactions to trauma may be short term and may not lead to permanent mental illnesses. As shown in Chapter 4, four themes emerged in this research study and provided a framework to determine the psychological consequences of Boko Haram for Nigerian children. Those themes were as follows:
1. Emotional grief, sadness, and sorrow 2. Struggling with education
3. Resilience program and support services: Prayer as robust support coping system
4. Social implications of receiving therapy
Themes were derived from the interview answers, which stemmed from questions linked directly to the research questions. This chapter provides interpretations of the research findings, with specific emphasis on how literature supports the results and phenomenon of the study participants' psychological experiences with the Boko Haram insurgency. This chapter addresses some of the limitations of the study. It also provides recommendations for further research on this topic and discussion of the study’s
implications for social change. The chapter concludes with a complete summary of this research study.
Interpretation of the Findings
The study confirms that children exposed to terrorism experience psychological trauma (Pine et al., 2005). For example, all of the study participants confirmed their grief, sorrow, frustration and exhibited psychological symptoms such as sadness, pain, shock, disappointment, disbelief, anger, sleeping phobia, fear, lack of appetite,
depression, emotional numbing, mourning, grief, insomnia, anxiety, feeling of upset, worry, avoidance, and sense of insecurity over the killings or kidnappings of their
parents, grandparents, friends, classmates, and/or teachers, and/or the destruction of their farm produce, farmland, and/or school by the Boko Haram insurgency.
Findings from the study also confirmed that the study participants exhibited avoidance, headaches, emotional numbing, and mourning more specifically within the first 3 months of experiencing the death or kidnapping of parents, other family members, or friends. However, the study participants’ responses to interview questions showed that these pathological reactions to terrorism were “normative responses” to unnatural acts that did not lead to permanent mental health illnesses. This confirms the findings of North and Pfefferbaum (2002), who stated that the distress that children suffer during exposure to terrorism is considered a “normative response” that may not necessarily be regarded as pathological.
All of the participants praised churches and mosques for their caring presence and prayers; they also identified encouraging themselves in the word of God. Participants acknowledged the effort of the government to provide security to their schools and communities. They also urged religious, governmental, and nongovernmental
organizations to provide support to other children who might seek similar help in the same situation.
Piaget’s cognitive development theory (CDT) and punctuated equilibrium theory (PET) were the theoretical frameworks that I used to interpret the findings from this research. Piaget developed cognitive development theory to focus on the mechanisms by which children develop and adjust to their environments (McLeod, 2015). CDT has been useful to researchers investigating the assimilation and accommodation of children in terms of educational performance (Balk, 2011). However, CDT was employed in this study to understand the assimilation and accommodation of the study participants after exposure to terrorism.
Data collated and analyzed in this study showed that the accounts of individual participants (who were between the ages of 11 and 18 years when they experienced the Boko Haram insurgency) indicated that these individuals attributed their memory loss, negative attitude toward schooling, weaker school performance, pessimism about life and the environment, poor concentration, low cognitive capacity, poor information
processing, and lack of creativity to their exposure to the Boko Haram insurgency.
However, the study participants did not exhibit permanent cognitive impairment. The specific behavior identified by the study participants at the formal phase aligns with Piaget’s CDT, which indicates that children who are exposed to violence and instability, who are taken out of school, and who experience displacement due to violence or disaster may suffer memory loss, weaker academic performance, and impaired assimilation and accommodation (Miller et al., 2000a). The study also confirmed the findings of Olff et
al. (2006) that children who lost their parents to terrorism through either death or
displacement experience poor information processing and lack of creativity, as posited by Piaget’s CDT.
The study participants’ accounts were often very detailed when they recounted their experiences with resiliency program and support services and identified prayer as a strong support coping method. The findings from this study showed that Nigerians are likely to consider any form of treatment once they have experienced psychological trauma. All of the study participants agreed that prayers and religiosity were the most reliable methods that helped them to overcome trauma; nevertheless, virtually all of the participants acknowledged that they had received clothing and temporary shelter from the government. The participants also recognized parental support, peer support, community support, counseling from churches and mosques, their individual religious background, and in-depth knowledge of the Bible and Koran (Bonanno et al., 2005; Ciccheti, 2010;
Cummings et al., 2011; Garbarino et al., 2015; Greeson, 2013; Hasija & Gray, 2007;
Moscardino et al., 2007).
All of the study participants were raised to follow Nigerian traditions and had specific mechanisms through institutions such as churches and mosques that allowed for the preservation of their values. Traditional Nigerian parents taught their children to rely on these institutions to cope with challenges, as demonstrated by the study participants when they recounted their experiences concerning what constitutes a mental health problem and how they relied on their religion and faith to cope with the trauma of being exposed to the Boko Haram attacks. The study participants conceptualized people with
psychological health illnesses as “crazy people” who walk on the street aimlessly without shelter and care. To them, avoidance, mourning, fear, numbing, and anxiety did not constitute mental health illnesses and were merely “normative responses” that did not indicate a pathological problem.
Many of the study participants identified shame and stigma attached to mental health illnesses in their communities, as well as financial challenges, transportation difficulties, lack of medicine, long hours of waiting to receive services at the hospital with no adequate experts for diagnosis, and corruption as some of the reasons why they did not receive treatment for mental health illnesses. Misinformation about what constitutes mental illness was a significant factor in study participants’ refusal to seek mental health intervention. Additionally, fear of being stigmatized for receiving mental health diagnosis and treatment was a concern that prevented participants from receiving therapy for mental health illnesses. Study participants considered the implications that receiving mental health diagnosis and treatment would have in relation to their family background, traditions, and cultural beliefs. All of the study participants relied on the healing power of God as alternative to receiving treatment for mental health illnesses.
This study confirmed the findings of studies that showed families’ complex needs, inadequate support for mental health, and corruption as impediments to mental health treatment for children (Barker-Ericken et al., 2013; Van Cleve et al., 2013). It also confirmed that lack of awareness about misconceptions concerning mental health
illnesses, inadequate awareness of what constitutes mental health illnesses, centralization of mental health resources, and poor skills related to mental health treatment on the part
of mental health service providers are challenges to providing efficient mental health services in Nigeria (Saraceno et al., 2007). The participants also identified lack of free medical care for children with mental health disorders as one of the reasons for staying away from therapy. One of the study participants noted lack of transportation and the high cost of hospital treatment as reasons for not entering treatment following exposure to trauma. All of the participants confirmed that lack of free health care services and lack of mental health support from the government were barriers to entering mental health therapy (Van Cleve et al., 2013; WHO et al., 2013).
Limitations of the Study
The purpose of this study was to examine the psychological consequences of the Boko Haram insurgency based on the lived experience of Nigerian children exposed to terrorism in northeastern Nigeria. Additionally, the goal was to examine factors that promote or hinder the development of resiliency among Nigerian children. In Chapter 1, I addressed limitations on generalizing the findings of the study, which derive from the fact that the participants were from northeastern Nigeria. Because Boko Haram activities occur across all six states in northeastern Nigeria, Nassarawa and Abuja (northcentral), and affected 3.7 million Nigerian children, it is not clear whether the experiences of these study participants in northeastern Nigeria reflect the lived experiences of other children affected by terrorism in Nigeria, and as such it may not be possible to generalize the lived experience of the study participants. Studies (e.g., Gasson, 2004; Goulding, 2002;
Kroening, Moore, Welch, Halterman, & Hyman, 2016; Morrow, 2005) have suggested member checking and thick description as methods of addressing the issue of
generalizibility in qualitative studies. This study applied member checking and thick description to improve accuracy and transferability.
The second limitation of this study had to do with the fact that the survey
questions were many and very broad, which resulted in the study participants responding to the questions based on their interpretations of them. To address this challenge, I conducted a pilot study to understand the capability of the respondents to answer the research questions and to determine if any changes to the interview schedule were required (Gil et al., 2008). Moreover, the questions did not point to specific government programs. The study participants identified a series of short resiliency programs
designed to help them cope with their trauma. Because most of the programs available to the participants were scattered without any form of cohesion between the government and nongovernmental organizations, the study participants could not distinguish support programs provided by the government from those provided by nongovernmental organizations. The pilot study was also used to determine which government programs and services were available to the study participants to help them cope with their trauma.
Another limitation had to do with issues of ethnicity and religion. All of the study participants were Hausa from the northern part of Nigeria, and participants were evenly divided between Muslim and Christian religious backgrounds. There were no other nationalities (e.g., Yoruba, Igbos, or Fulani people born in Maiduguri) among the participants selected to recount their experiences and thoughts regarding Boko Haram terrorist attacks. Further, there was no atheist or traditionally religious participants in this study.
Recommendations for Further Research
This doctoral dissertation relied on the lived experiences of study participants who had been exposed to Boko Haram. This study addressed a gap in the literature concerning the psychological effects of the Boko Haram insurgency on Nigerian children residing in Nigeria. This study addressed issues regarding how terrorism impacted participants’ educational experience, as well as available programs and services that were perceived by the study participants as being helpful in improving their ability to cope with the effects of terrorism. It also touched on programs and/or services that may help to promote coping and adjustment for this population, as well as barriers that exist to improving the mental health of children of Nigeria, through qualitative phenomenological study. Five recommendations for addressing the psychological consequences of
terrorism for Nigerian children are described below.
First, findings from this study suggest the need for additional quantitative and mixed methods research on the psychological consequences of terrorism for this
population. There is a need to quantify the data used in this study to find the correlation between the study participants’ subjective experiences and terrorism. To ascertain whether the study participants’ psychological response to the Boko Haram terrorist attacks was a “normative response” to unexpected acts, it is suggested that the longitudinal effect of psychological responses to the Boko Haram insurgency on the study participants be studied. It is also important that the longitudinal impact of terrorism on the educational experiences of the study participants be explored.
Second, there is a need to study Nigerian government policy responses to the mental health needs of people exposed to terrorism. Additional studies need to be conducted on mental health policies and programs of the Nigerian government that cater to the mental health needs of children who have experienced Boko Haram violence. All of the participants in the study reported that there were no government policies or
programs that catered to their mental health needs following the Boko Haram insurgency.
Third, activities of donors in northeastern Nigeria who are providing
psychological support to children exposed to the Boko Haram insurgency need to be studied, given that the study participants reported that the activities of these donor agencies made no appreciable impact on their psychological and economic needs.
Fourth, one of the outcomes of this study was that the study participants did not use available government resources to address their psychological trauma because of how they would be perceived for doing so. Hence, there is need for a study to assess
perceptions of mental health care and how these perceptions impacted the study participants.
Fifth, the study participants were restricted to people who had been exposed to the Boko Haram insurgency in Nigeria, and the data used for the results of this study were exclusively based on their lived experiences. However, Boko Haram activities are occurring throughout northeastern Nigeria and have spread to northcentral Nigeria.
There is a need to study the lived experiences of other participants from other geopolitical zones where Boko activities are being experienced. Such individuals might have
different views and opinions than the study participants in this study, which might yield mixed results.
Implications for Positive Social Change
Findings from this study mark a foundational step in describing the psychological consequences of Boko Haram insurgency on the lived experience of Nigerian children.
The research findings also suggested positive social change through the development and implementation of social programs which will decrease the psychological effects of terrorism for Nigerian children. The psychological consequences of terrorism on Nigerian children exposed to terrorism have been in existence for a very long time
(UNICEF, 2016). Studies showed that an estimated 3.7 million children exposed to Boko Haram insurgency mental health needs are unmet (Hawke, 2015; IOM, 2015). Policies and programs to address the mental health problem of Nigerian children have received minimal progress.
The failure to update the MHA to cater to the mental health need of children exposed to terrorism is a gap that continues to put Nigerian children into high risk of permanent psychological health illnesses. Failure to fix this problem is unjust, and inimical to the health of Nigerian children. The findings from this study revealed that the study participants needed support and care to address the psychological challenges that they experienced immediately following exposure to terrorism. There is need for consistent and constant support system for Nigerian children to support their coping with the trauma of violence. Although some researcher may argue that the grief and shock that accompanied the symptoms of the psychological problem is “normative" and
reasonable in the circumstances of children’s exposure to violence. However, failure to provide early diagnosis and treatment for children exposed to violence may lead to permanent mental health illness at long-term (Qouta et al., 2008). Poor information processing, lack of creativity, weak academic functioning, are cognitive effects for children exposed to terrorism in the short term and the long-term (Bonanno et al., 2010).
The Nigerian government MHA, policies and programs are failing to meet the mental health needs of children exposed to Boko Haram insurgency. Successful update of the MHA, as well as the development of policies and programs to support the psychological health of children exposed to terrorism, will have direct positive social change on the children and their families. The provision of immediate, straightforward, mental health diagnosis and treatment, as well as school-based mental health therapy, will play an essential role in extending care to the children with the greatest need.
Development organizations and mental health professionals have affirmative and professional obligations to aid disadvantaged children with mental health challenges.
Misconceptions about mental health and therapeutic support processes, corruption, and inadequate treatment facilities have widened the diagnosis and treatment gap in mental health for children in Nigeria. Nongovernmental organizations can help provide treatment, rehabilitation, community care, research, training, and capacity building for local mental health providers which may aid effective service delivery to children with mental health. Fredrickson (2005) suggested that professionals should actively promote policies that reduce social inequities rather than serve as neutral arbiters of policy.
Psychologists and professional mental health providers can use their knowledge and
expertise to counsel lawmakers and policymakers on the need to update the MHA as well as development and implementation of programs that support psychological health of children exposed to terrorism in Nigeria.
Over the years, government of Nigeria has made some progress in developing MHA to provide for the mental health of Nigerians. However, in the view of the emergence of terrorism in Nigeria, there is need for government to reconsider policies
Over the years, government of Nigeria has made some progress in developing MHA to provide for the mental health of Nigerians. However, in the view of the emergence of terrorism in Nigeria, there is need for government to reconsider policies